Indiana is one of 20 states and 6 cities selected to participate in the Medical Monitoring Project (MMP). The MMP is a new surveillance project funded by the Centers for Disease Control and Prevention (CDC) for HIV-positive citizens receiving primary medical care for their disease. It is also supported by the National Institutes of Health (NIH) and the Health Resources and Services Administration (HRSA).

Sites selected for this project are required to identify all physicians providing HIV primary medical care, which is defined as ordering CD4 counts, viral loads, and/or prescribing antiretroviral therapy. Once physicians are identified, they are then asked to supply the Estimated Patient Load (EPL) of HIV-positive patients they cared for during the previous year. Physicians who have a practice and share medical records are considered a single facility. Facilities are then assigned unique identifiers. The unique identifier and the EPL are then submitted to the CDC. The CDC, in turn, submits the information to the Rand Corporation, which randomly selects 40-60 facilities.

ISDH MMP staff will visit selected facilities and encourage providers to participate in the project, which entails supplying the list of HIV-positive patients they evaluated during April 1, 2006 to July 31, 2006. Patients on the list are then assigned unique identifiers, which are submitted to the CDC. The CDC again provides this information to the Rand Corporation for a random selection of 400 patients.

Patients in the randomly selected group are then contacted by either their physician or directly by ISDH MMP staff and encouraged to participate in the project. Participants receive a $25 gift card for their time. Patients are interviewed using a standard questionnaire, and questions focus on access to health care, unmet needs, sexual behavior, drug and alcohol history, and current HIV prevention activities. This information is sent to the CDC, where it is compiled and used in future guidance for implementation of HIV prevention and care services and State distribution of HIV dollars. The most recent national HIV surveillance project was conducted over 10 years ago. Since then, the nature of the disease has changed tremendously, requiring current relevant information to meet impact expectations. The MMP project is scheduled to run until 2008, but it is expected to be renewed through 2011.

Each selected patient will represent 20 citizens currently living with HIV in Indiana. The success of this project will require a high level of participation by both selected providers and patients. It is anticipated that selected physician offices will be contacted in mid-August 2006, and selected patient interviews will begin mid-September 2006.